Document Detail

The CarboMedics "top hat" supraannular prosthesis in the small aortic root.
MedLine Citation:
PMID:  7626869     Owner:  NLM     Status:  MEDLINE    
Twenty-three patients, 11 men and 12 women, with a mean age of 64 (range, 34 to 78) underwent aortic valve replacement (AVR) with a CarboMedics "Top Hat" supraannular prosthesis between March 1993 and August 1994. The top hat supraannular prosthesis, a standard bileaflet valve with the cuff transferred to the valve inflow level, allowed implantation of 21-mm, 23-mm, and 25-mm valves, where a standard 19-mm or 21-mm valve would have usually been placed. One patient who had been in preoperative cardiogenic shock died in the perioperative period. Another had an intraoperative cerebral embolism with permanent impairment. Follow-up on 22 of 23 patients over a mean period of 9 months revealed mean Doppler gradients of 18 +/- 6 mmHg, 15 +/- 2.8 mmHg, and 11 mmHg, for the 21-mm, 23-mm, and 25-mm valves, respectively. Functional improvement was noted, with 17 patients in New York Heart Association (NYHA) Class I and 6 in NYHA Class II, postoperatively, compared with 0 in Class I, 9 in Class II, 10 in Class III, and 4 in Class IV, preoperatively. One patient showed reduced postoperative ventricular function with fractional shortening below 25%. Pandiastolic regurgitation intrinsic to the valve graded as slight was noted in all patients. Other postoperative complications included one patient with anticoagulant-related gastrointestinal bleeding and one other with prosthetic valve endocarditis successfully treated with antibiotics. The CarboMedics top hat valve allows a gain in prosthesis size of 2 mm to 4 mm in the aortic position over standard prostheses, resulting in favorable postoperative hemodynamics.
S Roedler; A Moritz; M Wutte; R Hoda; E Wolner
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  10     ISSN:  0886-0440     ISO Abbreviation:  J Card Surg     Publication Date:  1995 May 
Date Detail:
Created Date:  1995-09-05     Completed Date:  1995-09-05     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  198-204     Citation Subset:  IM    
Department of Cardiology, University of Vienna, Währingergürtel Vienna, Austria.
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MeSH Terms
Aortic Valve*
Echocardiography, Doppler
Follow-Up Studies
Heart Valve Prosthesis* / mortality
Middle Aged
Prosthesis Design

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